A Systematic Review of Social Work in General Practice: Opportunities and Challenges

Figures & data

Table 1. Data extraction table.

Reference & Author’s country and institution	Type of study	Nature of social work practice?	Reported patient outcomes	Challenges	Benefits	Enablers of SW practice in GP clinics	Recommendations
1. Alvarez et al. (2018). USA School of Nursing- University.	Interviews with health care practitioners about the use of new App for Intimate Partner Violence [IPV] with Latino Women.	Counseling IPV referrals; counseling women who experienced IPV.			Referral to social worker for further support; Warm-hand off to social worker when IPV; Social Worker can assist women leaving violence; Social workers had more knowledge and training about IVP; Social workers supported undocumented Latina patients in crisis.		Social Workers to assist patients with IPV App.
2. Ashcroft et al. (2018). Canada School of Social Work; Centre for Family Medicine- University.	Survey with Social Work Practitioners to explore the integration of social work in Family Health teams.	Assessment; Counseling; Case Management; Community Development; Leveraging Resources; Group Work Employed as social workers (73%) or mental health counsellor/therapist/worker; Referrals; Family therapy; group work, counseling; community development; case management; psychosocial assessments.		Lack of Understanding of SW role; Management; Time Time constraints; decreased collaboration opportunities; “Long waiting lists, high demand for services, lack of resources, organizational policies, inadequate training, compassion fatigue, other health colleagues’ limited understanding of the social work role, and poor leadership” (p. 112–3); social change and transformation limited; lack of role-clarify; other team member expectations unclear; lack of available mentorship.	Triaging patient crisis; social work brings value to these interprofessional teams particularly in the areas of mental health, chronic disease, addictions, and geriatrics.	Funding; Interprofessional practice; Multiple Social Workers; Organizational structure; Referrals Systematic pan-Canadian Primary Health Care reform led to team based models of care; Social workers education and competencies; accessing supervision; collaborative engagement and building relationships with colleagues; Organizational structure with strong leaderships, interprofessional practice integration respected; two or more social workers in one setting; social work specific referrals.	Social workers need specialized training; education of educating health care team on social worker role and contribution to patient care; increased renumeration; increased support and leadership for social work.
3. Bench et al. (2020). USA School of Nursing- University.	Clinical study evaluating a collaborative care model to reduce depression and improve quality of life in older adults.	Support Provision Facilitate interactions with study participants;	Reduction in depression severity.		Social workers as primary clinicians increase direct and individualized involvement in health management; Social workers effectively collaborated on depression management.	Funding Federally funded collaborative care model to manage older adult depression in primary care settings.
4. Berger-Jenkins et al. (2019). USA Departments of Pediatrics; of Population and Family Health; of Psychiatry, obstetrics and Gynecology; of Psychology; of Biostatistics; Division of Social Work- University.	Young children well-being survey for quality improvement; data analysis of medical record.	Counseling Created electronical referral list for clinic. Worked with reported behavior problems and social stressors.	Positive child behavior or social stressor screens linked to 50% of referrals to clinical social workers.
5. Berrett-Abebe et al. (2020). USA Social Work Department; School of Public Health- University; Public Health Research- hospital; Health Policy Commission.	Survey of geriatrics and primary care practice about social worker and community health workers roles in the care of frail elderly patients in primary health settings.	Assessment; Case Management; Counseling Assessment of activities of Daily Living, social issues; care coordination for transitions. Treatment of mental and substance use disorders; advanced directive planning.		Lack of Understanding of SW role; Time Not enough time to schedule social work services to meet the needs of the frail elders; only a third of the practices employed social workers; social work expertise underutilized in practices with social workers; meeting social service needs of frail elders difficult.	Physicians undertake fewer social needs assessment and care coordination.	Funding Affordable Care Act 2010 leading to the inclusion of social workers and community health workers in health care teams.	Delegation of clinical tasks to social work to achieve more efficient practice and overall quality care; lead, supervise and training community health workers and students to free up GP and nurses’ time. Nurses and GP’s need better understanding of social work role; differentiate social workers’ advanced clinical competencies from the supportive role of community health workers.
6. Bina et al. (2018). Israel School of Social Work; College of Nursing and Health professions – University; Women’s and Children Health Research- medical Center; Social Services.	Qualitative study exploring social workers’ perspectives of implementing interpersonal therapy for women who have postpartum depression symptoms.	Case Management Addressing psychosocial issues related to health.		Lack of referrals; Time; Workload Limited referral from nurses; perception that nurses would not refer as social workers would remove babies; workload issues- limited time.		Funding Health care reform transferring psychiatric services to health maintenance organizations.
7. Brown et al. (2016) Canada, UK Departments of Family Medicine; Department of Epidemiology and Biostatistics; School of Medicine and Dentistry; School of Social Work- University.	Qualitative study exploring primary health care processes of Family Health teams.	Counseling, Leveraging Resources Social and emotional medicine areas; provide mental health services and resources; motivational interviewing.		Health Culture Balancing demand; bureaucratic barriers (lack of discharge information); Coordination and continuity of care; early prevention and health promotion; patient expression of health concerns; caring for the whole person, not just disease.	Value for money- managing patients; one stop shop; patient centered care.		Further research.
8. Chan et al. (2018) USA Divisions of General Internal Medicine and Geriatrics; and of Hospital Medicine, School of Social Work –University.	Randomized controlled study design to identify health disparities, integrated care models and health access.	Assessment; Case management; Counseling; Leveraging Resources Intake- Assess social vulnerabilities, counseling and case management; leveraging existing linkages to mental health prescribers.				Funding Funded through reallocation of existing staff resources and clinical budget; fee for service payments for patient visits for Medicaid.
9. Chang et al. (2018) USA Healthcare system; Center for study for HealthcareInnovation; Department of Medicine; Primary Care and Population health, division of Geriatrics- University; Center for Innovation to Implementation; Medical Center.	Reporting on demonstration sites for interdisciplinary care teams for intensive primary care of Veterans, including survey to team members.	Case management; Education; Leveraging Resources; Mediation; Support Provision of information and referrals; care planning; information provision; case management, facilitating family meetings; assisting with legal issues; carer education and support; housing option coordination.	Social work interventions effectively address psychosocial needs of complex clients.	Management Understanding which patients most fit for the program; stratify patients’ case management access.	Overcoming social barriers (housing, financial, legal needs) hindering patient engagement with health care through intensive social work case management.	Funding Veteran Health Administration implemented intensive primary care programs- primary care services funded.	Disseminate program more widely.
10. Cornell et al. (2020) USA Center of Innovation forLong· Term Services and Supports; National Social Work Program Office; Healthcare service; Medical Center; Veterans Health Administration.	Program evaluation of social worker inclusion in Veteran Health Administration primary care teams by evaluating patient data.	Assessment; Case Management; Leveraging Resources Visiting veterans; coordination of care/case management; comprehensive services; building relationships- assess suicidal ideation, social isolation and personal crisis; connect patients to treatment.	4.4% decrease of hospital admissions; 3% decrease of emergency department visits; decreased complications; patients’ social needs addressed.		Social determinants of high-risk, high need populations addressed; improved overall team’s effectiveness; other team members can do assigned jobs more effectively; link between various health teams; improved care coordination; reduced treatment delays.	Funding Veteran Health Administration National Social Work Program in collaboration with the Office of Rural Health started social work staffing program; Cost of social workers decreased by offset in urgent care; universal patient records support collaboration.	Research social determinants of health and impact of health care processes; coordination of health care needs; access to services (economic benefits, housing, caregiver support); explore optimal panel size for social workers on the team; provide additional funding for social workers.
11. Döbl et al. (2017). New Zealand University	Qualitative data collection examining social work integration into primary health care practices.	Counseling, Case management, Education; Assessment; Group Work Social justice and equity as key principles for practice; “referral, preparation, building rapport, assessment, setting goals and establishing a joint plan with clients (and their families) followed by tailored interventions which were continuously monitored and reviewed closure” (p. 123); “Interventions included advocacy, case management, liaison, referrals, information provision, practical and emotional support, counseling, health education, skill building and group work” (p.124).	Address wider health challenges.	Funding; Health Culture; Management; Space Funding and space; professional isolation; Equality and power-dominant Western health care model”- reinforcing power imbalances; Patients’ multiple interconnected health concerns.	Seeing patients wholistically- including lived environments and the interconnectedness of these aspects; person-centered; intensive practice knowledge about health information and government, social and community processes; Social workers asset to the team.	SW Articulation; SW Skills; Supports; Relationships Articulation of social work aims and skills; ability to communicate social work role; relationship building with patients, the team and the wider social service and health networks; good employment conditions; access to professional resources, i.e. supervision, professional development; professional membership fee payment.	Co-location for ease of information sharing; careful planning of home visits to ensure safety; inclusion of social workers in coordination of care; Government to allocate funding for integrated PHC model; Social work profession to evidence its usefulness.
12. Döbl et al. (2015). New Zealand School of Population Health, School of Counseling, Human Services and Social Work- University.	Qualitative data collection examining social work integration into primary health care practices.	Case management: Counseling, Leveraging Resources, Group Work Use of indigenous and other holistic health models; recognition of patients’ self-determination; “Tailored interventions included advocacy, case management, liaison, referrals, information provision, practical and emotional support, counseling, health education, discharge planning, skill building, and group work” (p.335); relationship building.		Funding; challenging issues experienced by communities.	Holistic, seamless healthcare particularly for vulnerable population; seeing needs holistic within the patient’s individual context; enhancement of quality and coordination of care, safety, and strengthening workforce; Enhancing access for and engagement by communities, in particular vulnerable groups.	Communication: Funding, SW Articulation; SW skills NZ Ministry of Health vision for Primary Health; Strong support of the practices; articulation of the role of the social work profession; ability to clearly communication their professional role and specific role in the practice; Clear communication; being a safe social worker (supervised; clear vision; practice standards and accountability); establishing trust.	Develop integrated PHC particularly for populations affected by social and health inequities.
13. Enguidanos et al. (2011) USA School of Gerontology- University; Care Foundation.	Control trial with patients exploring whether social work problem solving therapy with patients with multiple chronic conditions resulted in problem resolution and to identify problems.	Assessment; Case Management; Counseling Training Problem Solving Therapy sessions with older primary care patients; included assessment, problem solving skills training and intervention.	Exercise/weight loss;’ improved self-care.	Lack of attendance of participants resulting in 31% of patients attending 3 or fewer sessions;	Majority of problem identification by patients (92%) leading to an increased problem resolution rate; 59% of problems resolved within 10 weeks; access to medical care/equipment, house cleaning, disease information; home and personal organization, transportation, social activities, financial issues, advanced care planning, home improvement, psychological issues and meal preparation.		Social work intervention to allow patients to self-identify problems to support the goal achievement of primary care patients.
14. Hawk et al. (2015) USA Departments of Behavioral and Community Health; and of Public Health- University; Center for Practice Transformation and Innovation	Qualitative study with primary care practices exploring Chronic Care Implementation.	Case Management Coordinate patients’ behavioral health care; inform team about patient needs and challenges.	Improved patients’ behavioral health management outcomes.	Billing; Funding Payer driven care	Improved interprovider communication; Social workers’ coordination of behavioral service enabled implementation of Patient Centered Medical Homes; addressing barriers to patients’ care	Funding Affordable Care Act sparked reform of health care system including the patient centered Medical Homes	Further research how investment of funds can result into practice transformation to reduce costs, improve quality of care and community health status
15. Horevitz & Manoleas (2013) USA School of SocialWelfare- University.	Survey and Interviews assessing the primary skills and knowledge that social worker viewed as important in Integrated Behavioral Health.	Assessment; Case Management; Counseling; Education Psycho education; motivational interviewing; relaxation training; team based care; functional assessment, problem-solving treatment; alcohol and drug assessment/intervention				Funding; SW skills Affordable Care Act: key feature is patient centered medical homes; integrating behavioral services into primary care; “knowledge of psychotropic medication, interdisciplinary (team) collaboration, psychoeducation, knowledge of chronic illness and cultural competence” (p.766); Social work training; learning on the job.	Inclusion of competency areas in the MSW degrees: gerontology, motivational interviewing, mindfulness, screening tool, psychoeducation and psychotropic medication; social workers need knowledge of emerging evidence-based interventions, using care treatment algorithms, problem solving treatment and Alcohol and other drugs assessment and treatment in primary care.
16. Lahey et al. (2019) USA Social Work and Community Health, University medical center.	Case study of collaborative care team model connecting adolescent and adult patients with depressive symptoms to adequate care and support.	Assessment; Case Management; Counseling; Leveraging Resources Care management intervention; assess and address patients’ psychosocial and biosocial needs; review patient history; rapport building; explore behavioral health needs and treatment options; create care plan; connect to resources; case management, psychoeducation; psychotherapy.	Reduction of depressive symptoms; patient more connected to family and functional at school and work; patient engagement with behavioral resources.	Billing; Funding; Health Culture; Management Financial sustainability, i.e. billing with Medicare, Medicaid and others not possible leading to clinics needing to be creative with funding from grants and other payments; “historical fragmentation across care settings, time constraints, inadequate revenue sources, challenges accessing data” (p.104); health culture.	Social work practice resulted in escalation and access to psychiatry if needed; identification of patients’ preferences, values and barriers; psychoeducation leading to patient engagement; personalized care plans; better medication regime; Minimizing unnecessary medical appointments; mitigate psychiatry long waiting lists; identification of barriers of care (i.e. inadequate finances, food insecurity, and lack of transportation); person-centered care; increased resources for patient care; social work skills set meets patients and referring provider needs; wraparound care of social worker workers ensures successful behavioral treatment plan development and implementation; more patients attended to	Communication; Relationships; SW articulation Continual communication with clinical staff, providers and psychiatrists; interprofessional communication; Education on social work training and scope of practice; joint work to build trust and reinforce benefit of social work intervention; training social workers to do screening; innovative approaches to overcome barriers, i.e. in-home options to provide services.	Social workers to document their services; “research their return-on-investment, and advocate for further reimbursement avenue” (p. 103); address challenge of integrating social work care in health culture.
17. Mann et al. (2016) USA Departments of Psychiatry, Behavioral Sciences; of Family and Community Medicine, social work, continuous quality improvement- University.	Case study of integrating Behavioral Health Consultants [BHC] into primary care settings.	Assessment; Case Management; Counseling; Leveraging Resources; Training Patient counseling (stress management, physical activity, alcohol consumption, other health related issues); assessment and interventions, “motivational interviewing, behavioral activation, solution-focused techniques, relaxation training, and cognitive-behavioral approaches” (p. 198); case conferences, referrals.	Address barriers to disease self-management (often anxiety and stress); decrease of glucose levels; better equipped to deal with stress; reported higher quality of life;	Billing; Funding; Lack of Understanding of SW role;Communicating BHC role to health care team members; inappropriate referrals; only 25% of providers refer regularly, others only when “stuck” with patients; integration into daily workflow- referral systems; clinic layout not conducive to collaboration; patients’ expectation of longer interventions; missed appointments; billing codes not suitable; not funding priority.	Freeing up physician’s time; improvement of overall mental and social conditions; wholistic care leading to health improvements; advocacy for the most vulnerable.	Funding; Relationships; Shared Spaces; SW skills Continual emphasis on how behavioral issues impact all health problems- communicate this; Affordable Care Act of 2010 led to increase of adoption of patient-centered medical model of care; formally and informally to team members; “warm-handover;” social worker understanding workflow of clinics; shared workspaces- physical proximity allows for collaborative discussions and warm hand offs; shadowing team members to achieve integrated care; building rapport with other health professionals.	Record cost saving
18. Ní Raghallaigh et al., (2013) Ireland School of AppliedScience- University.	Survey and focus groups interviews with primary care social workers to explore social workers role in primary care teams.	Case Management; Counseling; Leveraging Resources Case work: financial difficulties, loneliness and isolation, difficulties arising from disability or coping with physical illness; Individual therapeutic work and practical support; responding to elder abuse.	Being well and alive; respect, self-determination, and empowerment- alternative to medical model.	Lack of understanding of SW role; Management; Resources; Workload. Cut backs and lack of resources; insufficient number of primary care social workers; waiting lists; management structures; interdisciplinary work; threat of redeployment to child protection; some disciplines missing from interdisciplinary teams; some teams not being co-located; lack of understanding social work role and making assumptions about the role; referral of complex cases- “we have had enough of her” (p. 941); inappropriate referrals; care teams “not actually functioning as teams (e.g. an absence of team responsibility for clients, a lack of co-location, team members not attending meetings)” (p.943);	Learning from each other (professions); opportunity for interdisciplinary collaboration; diversity and flexibility of work; willing to meet patients in their own home; patients given time and space to tell their story.	Funding Framework of establishing a more comprehensive primary care service introduced in the Health Strategy in Ireland, leading to the Primary Care Strategy and primary care teams.	Carve out the social work niche; “regular professional support and supervision from more senior staff within primary care, rather than from senior staff working in other areas of social work” (p.944); collectively articulate social work role.
19. Rabovsky et al. (2017) USA School of Medicine andCollege of Medicine -University; Medicine Institute.	Retrospective review of patients’ records to explore impact of social work intervention with patients with diabetes and cardiovascular risk factors in primary care sites.	Leveraging Resources; Support Provision Addressing social determinants of health (medication, health insurance, stress, social exclusion, work, addiction, food, transport and social support); referral to mental health provider; resource broker	Improved disease control for patients with uncontrolled diabetes (control of diabetes, blood pressure, cholesterol and glycemic control)	Time Providing tangible resources time-consuming impacting ability to provide counseling	Address cost-related underuse of medication;		Research to explore with aspects of social work practice specifically affects chronic disease control level
20. Reckrey et al. (2014) USA School of Medicine-University.	Description of social work integration into team approach of homebound services.	Assessment; Case Management; Leveraging Resources; Support Provision; Training Obtain benefits; home care service coordination; connection to community resources; support patients and carers with end of life issues, relationship issues and housing; screen patients for unmet needs; develop collaborative intervention plan; education of staff and students; supporting internships; newsletter to patients; lead team meetings; health protocol development; risk and safety assessment.	Decreased unmet needs.		Assist carers manage stress; comprehensive patient care not captured in other roles; individualized care for patients; Assist “patients cope with their complex chronic illness and proactively address problems that inhibit quality care, they provide counseling to help address depression and anxiety among patients and caregivers, and they support patients and families who are facing serious and often life-limiting illnesses” (p.338).	Relationships; SW articulation Clarification of social work roles and team goals; “biweekly team meetings to foster effective communication and interdisciplinary team building “(p.340).	Research impact of social work on patient centered outcomes
21. Reckrey et al. (2015) USA Department ofMedicine, School ofMedicine- University	Quantitative study to review of patient data to compare patients in team care and patients receiving usual care and online survey of patients and physicians.	Case Management; Leveraging Resources; Support Provision. Work with specific problems (home care services, financial problems, patient and care giver coping, abuse or neglect concerns; psychosocial intake; actively addressing psychosocial concerns.		Reactive; Workload Social work involvement reactive in nature- limiting or delaying the social work intervention; increased workload.	Personnel cost reduction of 20% in team approach; physicians could increase their patient load; physicians more able to meet patient needs and maintain own emotional health; improved ability to provide immediate support; improved job satisfaction.	Relationships Assessing capacities and needs of nonphysician team members; regular meetings for program review and implementation.	Research to address non-physician satisfaction with team approach.
22. Rehner et al. (2017) USA University	Case study research of implementation of social work in integrated system of care.	Assessment; Case Management; Counseling; Education; Leveraging Resources; Support Provision. Chronic Condition support program- Services to patients with uncontrolled diabetes; assessment of mood disorders, environmental, social, behavioral and financial health factors; collaborative development of care plans; addressing barriers to overall wellbeing; education to improve health literacy; linking to resources; problem solving; motivational interviewing and treatment of mood disorders.	General improvements in physical health; statistically significant improvement in patient health scores in anxiety, depression and diabetic self-care activities.	Health Culture; Management; Reporting; Space Working in other locations required cultural and structural changes to primary care systems; Social workers outside the main patient allocation of treatment rooms impacting patient access and inhibits collaboration; data collection system focused on medical providers, lacked ability to capture mental health interventions and patient outcomes.	Overall wellbeing focus rather than just mental health concerns; 300% increase of patient contact- half focused on chronic care support; increased collaboration by all providers resulted in adjustments of their views of patient care; i.e. medical practitioners reached out to social workers to address psychosocial needs; social workers realized that sole focus on mental health not enough; training of social work students in health; addressing social determinants of health improves patient health outcomes with chronic health conditions.	Funding; SW articulation; Financial resource allocation by Gulf Regions Health Outreach Program through court decision in the wake of environmental disaster; Chronic Condition Support program to actively pursue patients by consulting with the primary care provider to “patients who would benefit from behavioral health services”- S42 resulted in direct referrals, development of a curriculum. Social work staff acquiring extensive	Social workers to learn medical terminology and adapt interventions to support behavioral changes that benefic overall health best; clinic staff link emotional and physical health in treatment plan; both aspects of health to be discussed in every patient session.
						knowledge about chronic health conditions and adjusting to health setting; self- advocacy and marketing by social workers; market social work and what they could offer; argue ecological perspective- addressing social determinants of health that negatively impact patient compliance and outcomes; adaptability to specific clinic culture and setting; reduce traditional 60 min social work appointments to 30 minutes timeslot to support workflow of provider and patient volume.
23. Rowe et al. (2017) USA Department of SocialWork University;Health and Aging- University Medical Center.	Case study analysis of a social work care coordination model; data sources were case notes.	Assessment; Case Management; Counseling; Leveraging Resources; Support Provision. Patient engagement, assessment and care plan development; care coordination activities; goal attainment- link goals to desired health outcomes identified by patient and reinforcing patient strengths; ongoing care- ensuring community resources are in place for patient support; motivational interviewing; relational techniques; psychoeducation with patient- connection between depression and disease management.	Patient expressing optimism about the future and ability to seek help; anticipated reduced need for ED services and future hospitalizations.		Patient able to recognize that accepting support important for maintaining independence; referral to services; patient approved for Medicaid, and other financial assistance; primary care provider gained Insight into patient’s motivating beliefs and values; Social work intervention to access financial help; increased the job satisfaction of primary care provider; Social workers more efficient in addressing non-medical needs due to training and expertise; Primary care provider informed of patients goals and the services provider which will guide future work with patient- Primary care provider informed about patients involvement and collective ownership learning to improved health and patient outcomes.	Funding; Relationships; SW skills Social work skills to establish trust and collaborative working; Accountable Health Communities federal funding demonstration projects and Affordable Care Act; relationship with patient.	Addressing non-medical needs required specialized set of skills- patient and care coordination and behavioral health treatment; knowledge of interplay of person-centered care and person in environment approaches; valuing patient strengths and individual motivation; research into social work intervention and health cost needed; Changed to billing codes and payments for social work in primary health care setting needed.
24.Saavedra et al. (2019)MexicoEpidemiology and psychosocial research- Institute of Psychiatry.	Exploratory sequential mixed method design involving interviews and surveys to characterize the role of social workers in health centers.	Case Management; Counseling; Leveraging Resources; Education; Support Provision; Training Preventative, educational, health care and health promotion services; direct care; information provision; group work, facilitate patient access to health services, home visits; psychoeducation; referral to specialists; advocacy; assisting patients to mobilize resources; counseling; listening – allowing patients to vent their emotions.	Soothing and calming patients; providing emotional relief to patients so they do not leave in the state they arrived.	Health Culture; Hierarchy; Lack of recognition. Social workers receive little recognition for work in this area in the context of a medical system not considering the social view of illness; biomedical view ascribing social workers lesser status in medical system and devaluing their work; no place to record the listening and support work of social workers or the social study of cases; strict hierarchy resulting in health professionals not being accustomed to being questioned or criticized.	Social work interventions address the shortage of specialists and allow patients to vent their emotions; familiarity of social workers with social complexities of the populations can help activate patients social networks; social workers’ observation of context and characteristics of patients allowed identification of mental illness; ability to work with sensitivity with psychiatric patients and provide them with information; assisting patients to talk about common problems (finances, family, neighborhood safety, partner and family violence); social workers combine physical, mental, emotional and social work aspects in patient care in ways that is lacking from other health providers; identification of factors such as poverty and partner and family violence as impacting patient mental health; quality patient care.	Funding Funded positions administering patient access to health care; Program established by Secretary of Health.	Hiring specialized staff, timely detection and community education, infrastructure improvement and staff training to improve mental health patient care; importance of making the daily work of social workers visible; Simplification of forms and records to reduce administrative load of social workers.
25. Safren et al. (2013) USA Department of Psychiatry hospital and medical school; Health institute	Evaluation of 5 intervention visits of HIV infected men with social workers.	Assessment; Case Management; Education; Intake and assessment; building rapport; psychoeducation about HIV transmission (sex, party drugs, managing stress reduction, mindfulness, skills building and relaxation training; goal setting.	Reduced risk for Transmission -risk Behaviors and Outcomes.
26. Tadic et al. (2020) Canada Faculty of Social Work, Department of Family Medicine- University; Health Care Research Center.	Survey to identify among and type of social work services in primary health setting.	Case Management; Counseling; Education; Group Work; Support Provision; Preventive care and health promotion, palliative care; healthy behavior and self-management groups; psychosocial services; primary mental healthcare services; liaison with other health care organizations; home visits; lifestyle counseling; end of life/palliative care; patient self-management and chronic disease management; program implementation.		Reporting Lack of data to help demonstrate the impact of social work services; difficult to capture social work contributions to care in administrative data bases;	Social workers deliver and support mental health care broadly to encompass a broad set of services contributing to individuals’ wellbeing and health.	Funding Systematic pan Canadian primary health reform leading to inclusion of social workers in Primary Health Care settings;	collaboration between Social work and Medical professional associations to help maximize scope of social work practice in primary health care; training of social workers for multiple modalities required in comprehensive and fast-paced Primary Health Settings; include social work students in interdisciplinary student training to include social work perspectives and skills.
							collaboration between Social work and Medical professional associations to help maximize scope of social work practice in primary health care; training of social workers for multiple modalities required in comprehensive and fast-paced Primary Health Settings; include social work students in interdisciplinary student training to include social work perspectives and skills.

Figure 1. PRISMA Flowchart- Identification of studies.

Table 2. Methodological quality appraisal of the included studies.

Reference	Study design	Qualitative	Quantitative	Mixed methods	CASP score	EPHHP Score
Alvarez et al. (2018)	Interviews	x			Strong
Ashcroft et al. (2018)	Survey		x			Weak
Bench et al. (2020)	Cohort		x			Weak
Berger-Jenkins et al. (2019)	Document analysis		x			Moderate
Berrett-Abebe et al. (2020)	Survey		x			Moderate
Bina et al. (2018)	Interviews	x			Strong
Brown et al. (2016)	Interviews	x			Strong
Chan et al. (2018)	Randomized Control Trial		x			Strong
Chang et al. (2018)	Case study			x	Weak	Weak
Cornell et al. (2020)	Evaluation		x			Moderate
Döbl et al. (2017)	Interviews	x			Strong
Döbl et al. (2015)	Interviews	x			Strong
Enguidanos et al. (2011)	Randomized Control Trial		x			Strong
Hawk et al. (2015)	Interviews	x			Strong
Horevitz & Manoleas, 2013	Survey		x			Moderate
Lahey et al. (2019)	Case Study	x			Weak
Mann et al. (2016)	Case Study	x			Weak
Ní Raghallaigh et al. (2013)	Survey and Focus group			x	Moderate	Weak
Rabovsky et al. (2017)	Document analysis		x			Moderate
Reckrey et al. (2014)	Case Study	x			Weak
Reckrey et al. (2015)	Case Study		x			Weak
Rehner et al. (2017)	Case Study		x			Weak
Rowe et al. (2017)	Case Study	x			Strong
Saavedra et al., 2019	Case Study			x	Strong	Strong
Safren et al. (2013)	Randomized Control Trail		x			Strong
Tadic et al. (2020)	Survey		x			Moderate

Alvarez, C., Debnam, K., Clough, A., Alexander, K., & Glass, N. E. (2018). Responding to intimate partner violence: Healthcare providers’ current practices and views on integrating a safety decision aid into primary care settings. Research in Nursing & Health, 41(2), 145–155. https://doi.org/10.1002/nur.21853

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Ashcroft, R., McMillan, C., Ambrose-Miller, W., McKee, R., & Brown, J. B. (2018). The emerging role of social work in primary health care: A survey of social workers in Ontario family health teams. Health & Social Work, 43(2), 109–117.

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Bench, V. R., Beach, M., & Ren, D. (2020). Evaluation of an adapted collaborative care model for older adult depression severity reduction and quality of life improvement. Journal of Evidence-Based Social Work, 17(5), 527–537. https://doi.org/10.1080/26408066.2020.1768193

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Berger-Jenkins, E., Monk, C., D’Onfro, K., Sultana, M., Brandt, L., Ankam, J., Vazquez, N., Lane, M., & Meyer, D. (2019). Screening for both child behavior and social determinants of health in pediatric primary care. Journal of Developmental and Behavioral Pediatrics, 40(6), 415–424. https://I0.1097/DBP.0000000000000676

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Berrett-Abebe, J., Donelan, K., Berkman, B., Auerbach, D., & Maramaldi, P. (2020). Physician and nurse practitioner perceptions of social worker and community health worker roles in primary care practices caring for frail elders: Insights for social work. Social Work in Health Care, 59(1), 46–60. https://doi.org/10.1080/00981389.2019.1695703

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Bina, R., Barak, A., Posmontier, B., Glasser, S., & Cinamon, T. (2018). Social workers’ perceptions of barriers to interpersonal therapy implementation for treating postpartum depression in a primary care setting in Israel. Health & Social Care in the Community, 26(1), e75–84. https://doi.org/10.1111/hsc.12479

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Brown, J. B., Ryan, B. L., & Thorpe, C. (2016). Processes of patient-centred care in family health teams: A qualitative study. Canadian Medical Association Open Access Journal, 4(2), E271–276. DOl. https://doi.org/10.9778/cmajo.20150128

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Chan, B., Edwards, S. T., Devoe, M., Gil, R., Mitchell, M., Englander, H., Korthuis, P. T. Korthuis, P. T. (2018). The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: Study design and rationale. Addiction Science & Clinical Practice, 13(1), 1–11. https://doi.org/10.1186/s13722-018-0128-y

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